ENERGY AUDIT QUESTIONNAIRE

Take advantage of natural light, when available

Remove unnecessary fixtures
Replace standard wall switches with occupancy sensors

General

Step 2: Insulation

Contact name:
Address:
Phone:
Email:

Do you have insulation in your wall? No Yes

What is the R-Value? What is the thickness?
Do you have insulation in your ceiling? No Yes
What is the R-Value? What is the thickness?

Square footage of home:

Step 3: Air Conditioning

Do you own your home: No Yes

Is your home more than five years old? No Yes

Do you have Air Conditioning? No Yes

Do you have a regular maintenance schedule for heating/cooling equipment? No Yes
Who is your HVAC service contractor? When was the last date of service?

How many years since your last remodel?

Step 1: Lighting

Air Conditioning Tips

Replace older systems with energy-efficient systems
Install ceiling and wall insulation
Service your equipment on the schedule your HVAC service contractor recommends

1. Number of incandescent lights:

2. Number of fluorescent lights:
3. N.B. Standard T12 lighting has two pins on the end and the light itself is 1 inch
diameter. If you are unable to remove a light to check, look to see if the home owner
has extras in storage and check those.
4. Do you have occupancy sensors or lighting controls on the interior? No Yes
5. Are they LED or incandescent? Incandescent LED
6. How many exits (doors/ windows) are there?

Lighting Tips
Retrofit T12 lights to T8 lights with electronic ballasts Turn off some of your lights if you can
Remove lamps - consider disconnecting power to unused ballasts
Replace incandescent light lamps with compact fluorescent lamps
Install dimmer switches, where applicable
Control exterior lighting with a photocell/time clock
Reduce ambient light and increase task lighting
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Step 4: Water Heating

How do you heat your water for your home?
None Gas Water Heater
Electric Water Heater

Solar Water Heater

Step 5: Foodservice equipment

Refrigeration:
Do your refrigerator doors seal correctly? No Yes
Do you maintain the proper temperatures? No Yes No
Who is your refrigeration service contractor? When was the last date of service?
Cooking:
Do you turn equipment off when not in use? No Yes
Do you have a maintenance program for cooking equipment? No Yes
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Is your equipment rated for energy efficiency, such as ENERGY STAR

? No Yes

Foodservice Equipment Tips

Keep equipment cleancarbon and grease build-up make your cooking equipment work
harder and use more energy
Run full loads when you use your dishwasher
Turn off tank heaters and hot water recirculation pumps when the facility is closed
Look for ways to reduce hot water use in the kitchen
Fix water leaks one leaky faucet can waste up to 2,000 gallons of water per year
Use a lid on stockpots to hold in heat, boost efficiency and shorten cook times
Replace older equipment with ENERGY STAR rated equipment

Step 6: Equipment
Do you have ENERGY STAR rated equipment? No Yes
Are your computers, monitors and other equipment plugged into a power supply strip that
can be switched off during non-use hours? No Yes

Equipment Tips
Turn off all equipment and lights every night if you cant turn off the computer, turn off the
monitor and the printer
Purchase ENERGY STAR computers, monitors, printers these models "power down" after a
user-specified period of inactivity
Use laptop computers and inkjet printers they consume 90 percent less energy than
standard desktop computers
Use e-mail instead of printed documents

Step 7: Make Improvements

After reviewing this form what energy saving projects are you looking to implement today?
Foodservice
Water Heating
Air Conditioning
Insulation
Lighting